| NPI | 1427440189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MICHAELS MILLER Owner 703-887-9476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904003516) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-07-01 |